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COMPLIANCE INFO_2023
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0220079
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
4/12/2023 10:26:43 AM
Creation date
2/3/2023 4:50:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0220079
PE
2250
FACILITY_ID
FA0000187
FACILITY_NAME
JR SIMPLOT CO
STREET_NUMBER
16777
STREET_NAME
HOWLAND
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19818005
CURRENT_STATUS
01
SITE_LOCATION
16777 HOWLAND RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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J.R. Simplot Company SEND RESULTS TO ALL PARTIES LISTED BELOW. <br /> P.O. Box 198 <br /> Lathrop, CA 95330 Jacob Staley 209-858-6427 <br /> 209-858-2511 <br /> Krista Kinsey 208-780-7241 <br /> Rita Dunn 209-858-6470 <br /> Krista.Kinseve-simnlot.com <br /> JacoJtaley Sirnplot.com <br /> Rita.DunnSimplot.com <br /> Project ID NA Project CFA Used Reagents <br /> Name: <br /> i <br /> Remarks: <br /> COLLECTED BY: Jacob Staley <br /> SPECIAL Analyze for pH also. <br /> INSTRUCTIONS: Only run the STLC on any CAM 17 metals that exceed the l OX Rule <br /> (X) CAM 17-TTLC TURNAROUND <br /> ANALYSIS ( ) 8 Metal TCLP TIME <br /> REQUESTED (X ) STLC IOX Only(if needed) <br /> (X) Other,Note above in Special Instructions Section <br /> —1 <br /> i <br /> Sample ID I Lab ID Collection Matrix (dotes or Sample Map, Etc. <br /> Date <br /> A 47 <br /> CFA Used Reagentsta.7 02/10/2023 # igrrix <br /> SO <br /> JIYF�4 <br /> 1 <br /> Relinquished By: Jacob Staley Date 20/10/2023 Received By. p ` � ��(� Date <br /> &Time 1:00 pm I /` Y &Time <br /> Relinquished By: Date Received By: Date <br /> &Time &Time <br /> Send Sample To: Enviro-Chem, Inc. Laboratories <br /> 1214 E. Lexington Avenue <br /> Pomona, CA 91766 <br /> Ph: 909-590-5905 <br /> Fax: 909-.590-5907 <br /> CA-DHS ELAP Certificate #1555 <br /> CHAIN OF CUSTODY RECORD <br />
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